What is the treatment for a scrotal yeast infection?

Treatment of Scrotal Yeast Infection

For scrotal yeast infection, topical antifungal creams such as clotrimazole 1% cream applied to affected areas for 7-14 days or miconazole 2% cream applied for 7 days are the recommended first-line treatments. 1

Diagnosis Confirmation

• Before initiating treatment, confirm the diagnosis through microscopic examination with saline and 10% potassium hydroxide to demonstrate yeast or hyphae 1
• A normal pH (4.0-4.5) should be checked to help differentiate from other conditions 1
• Candida species are the most common causative organisms, with C. albicans being predominant 2

Treatment Options Based on Severity

First-line Treatment for Mild to Moderate Infection

• Topical antifungal options:
  • Clotrimazole 1% cream applied to affected areas for 7-14 days 1, 2
  • Miconazole 2% cream applied to affected areas for 7 days 1, 2
  • Butoconazole 2% cream applied for 3 days 1, 2

For Severe Infection

• Longer duration of topical therapy (7-14 days) 1
• Alternatively, oral fluconazole 150 mg every 72 hours for a total of 2-3 doses 1

Treatment Efficacy

• Topical azole drugs are more effective than nystatin for treating yeast infections 2
• Treatment with azoles results in relief of symptoms and negative cultures in 80%-90% of patients who complete therapy 2
• Both topical and oral antifungal formulations achieve >90% response rates for uncomplicated infections 1

Special Considerations

For Recurrent Infections

• Initial induction therapy with topical agent for 10-14 days 1
• Followed by maintenance therapy with fluconazole 150 mg weekly for 6 months if infections are frequent 1

For Non-albicans Candida Species

• Consider alternative treatments such as:
  • Boric acid 600 mg in gelatin capsule daily for 14 days 1
  • Nystatin preparations for 14 days 1

For Patients with Diabetes

• Establish and maintain good glycemic control as high blood glucose levels promote yeast growth and interfere with immune responses 3
• More aggressive and prolonged treatment may be needed for diabetic patients 3

Follow-up

• Follow-up visits are unnecessary if symptoms resolve 2
• Any patient whose symptoms persist after using treatment or who has a recurrence of symptoms within 2 months should seek medical care 2

Prevention Strategies

• Maintain good hygiene of the genital area 3
• Keep the area dry and wear loose-fitting cotton underwear 3
• For uncircumcised men, proper hygiene of the space underneath the foreskin is important to prevent yeast growth 3